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151.
Successful treatment of severe refractory autoimmune hemolytic anemia after hematopoietic stem cell transplant with abatacept 下载免费PDF全文
152.
Camille Chatelle Solveig L. Hauger Charlotte Martial Frank Becker Bernd Eifert Dana Boering Joseph T. Giacino Steven Laureys Marianne Løvstad Petra Maurer-Karattup 《Archives of physical medicine and rehabilitation》2018,99(9):1755-1762
Objectives
To investigate the relation between consciousness and nociceptive responsiveness (ie, Nociception Coma Scale–Revised [NCS-R]), to examine the suitability of the NCS-R for assessing nociception in participants with disorders of consciousness (DOC), and to replicate previous findings on psychometric properties of the scale.Design
Specialized DOC program.Setting
Specialized DOC program and university hospitals.Participants
Participants (N=85) diagnosed with DOC.Interventions
Not applicable.Main Outcome Measures
We prospectively assessed consciousness with the Coma Recovery Scale–Revised (CRS-R). Responses during baseline, non-noxious, and noxious stimulations were scored with the NCS-R and CRS-R oromotor and motor subscales.Results
CRS-R total scores correlated with NCS-R total scores and subscores. CRS-R motor subscores correlated with NCS-R total scores and motor subscores, and CRS-R oromotor subscores correlated with NCS-R total scores as well as verbal and facial expression subscores. There was a difference between unresponsive wakefulness syndrome and minimally conscious state in the proportion of grimacing and/or crying participants during noxious conditions. We replicated previous findings on psychometric properties of the scale but found a different score as the best threshold for nociception.Conclusions
We report a strong relation between the responsiveness to nociception and the level of consciousness. The NCS-R seems to be a valuable tool for assessing nociception in an efficient manner, but additional studies are needed to allow recommendations for clinical assessment of subjective pain experience. 相似文献153.
154.
Ulla A. Botha Marise Coetzee Liezl Koen Dana J.H. Niehaus 《Archives of Psychiatric Nursing》2018,32(3):384-389
Introduction
Pressure on inpatient beds often results in premature discharges, which may precipitate early readmission. This has prompted an increased interest in transitional care interventions to bridge the gap between in- and outpatient care to reduce such readmissions. Our study aimed to assess the effect of a Transitional Care Service (TCS) on readmission rates in a high pressure inpatient service which utilizes a premature discharge policy to address bed pressures.Methods
Sixty male patients identified for crisis discharge were offered a TCS for the first ninety days after discharge. Patients received a structured intervention consisting of four phone calls and one home visit, focusing on maintaining adherence, appointment reminders and psychoeducation. The TCS patients were retrospectively compared to a matched control group in terms of readmission after 90 days. Data was collected on adherence to medication, attendance of appointments and incidence of substance use.Results
There was no significant difference in readmission rates. Prevalence of substance use was very high (90%), especially methamphetamine use (48%). Adherence dropped from 45% (n = 27) at one week post-discharge to 25% (n = 15) at 90 days.Conclusion
Structured telephone-based transitional interventions have no effect on readmission rates in this setting. Prematurely discharged patients require more comprehensive support with focus on comorbid substance use. 相似文献155.
Purpose
To investigate the effect of host immunity (allospecific) and surgical manipulation (non-allospecific) on corneal endothelial cells (CECs) in corneal transplantation.Methods
Draining lymph nodes and grafted C57BL/6 corneas were harvested from syngeneic recipients, allograft acceptors, and allograft rejectors (BALB/c) 1, 3, and 8 weeks after transplantation. We analyzed CEC apoptosis using an ex vivo cornea-in-the-cup assay, and visualized cell-to-cell junctions using immunohistochemical staining (ZO-1). Automatic cell analysis using Confoscan software was used to measure CEC density as well as changes in CEC morphology by quantifying the coefficient of variation in cell size (polymegethism) and shape (pleomorphism).Results
The cornea-in-the-cup assay showed that allogeneic acceptor T cells and to an even greater extent rejector T cells (but not syngeneic T cells) induced CEC apoptosis. CEC density after corneal transplantation was significantly reduced in allogeneic acceptors compared with syngeneic grafts (P<0.001), and CEC density was even further reduced in the allo-rejector group compared with the allo-acceptor group. Allogeneic grafts showed a greater increase in the coefficient of variation in cell size (polymegethism) when compared with syngeneic grafts 1 week after transplantation (P=P<0.001). However, pleomorphism was not significantly different between syngeneic and allo-acceptor grafts, indicating that polymegethism (but not pleomorphism or cell density) is a sensitive indicator of the effect of alloimmunity on CECs.Conclusions
Our data demonstrate that host alloimmunity rather than surgical manipulation alone is the major cause of CEC damage in corneal transplantation, and such morphologic changes of CECs can be detected before the clinically visible onset of allograft rejection. 相似文献156.
Ahmad M. Mansour Dana Hasbini Muhammad H. Younis M. Tariq Bhatti 《Case reports in ophthalmology》2015,6(1):106-109
A 2½-year-old girl developed a bilateral occipital infarct following severe gastroenteritis with bilateral vision of light perception. Evaluations for sickle cell anemia, hemolytic anemia and coagulopathies were negative. Cortical blindness is an uncommon but dramatic complication of gastroenteritis, hence the need of prompt hydration and other supportive measures to avoid irreversible visual loss or mental sequela.Key Words: Occipital infarct, Gastroenteritis, Visual recovery 相似文献
157.
158.
M. Camille Harris Eric J. Dotseth Bryan T. Jackson Steven D. Zink Paul E. Marek Laura D. Kramer Sally L. Paulson Dana M. Hawley 《Emerging infectious diseases》2015,21(4):646-649
La Crosse virus (LACV), a leading cause of arboviral encephalitis in children in the United States, is emerging in Appalachia. For local arboviral surveillance, mosquitoes were tested. LACV RNA was detected and isolated from Aedes japonicus mosquitoes. These invasive mosquitoes may significantly affect LACV range expansion and dynamics. 相似文献
159.
160.
Noise-induced hearing loss (NIHL) has been extensively studied in industrial work environments. With the advent of new technologies, loud music has been increasingly affecting listeners outside of the industrial setting. Most research on the effects of music and hearing loss has focused on classical musicians. The purpose of the current study was to examine the relationship between the amount of experience a professional pop/rock/jazz musician has and objective and subjective variables of the musician''s hearing loss. This study also examined professional pop/rock/jazz musicians’ use of hearing protection devices in relation to the extent of their exposure to amplified music. Forty-four pop/rock/jazz musicians were interviewed using the Pop/Rock/Jazz Musician''s Questionnaire (PRJMQ) in order to obtain self-reported symptoms of tinnitus and hyperacusis. Forty-two of the subjects were also tested for air-conduction hearing thresholds in the frequency range of 1-8 kHz. Results show that the extent of professional pop/rock/jazz musicians’ exposure to amplified music was related to both objective and subjective variables of hearing loss: Greater musical experience was positively linked to higher hearing thresholds in the frequency range of 3-6 kHz and to the subjective symptom of tinnitus. Weekly hours playing were found to have a greater effect on hearing loss in comparison to years playing. Use of hearing protection was not linked to the extent of exposure to amplified music. It is recommended that further research be conducted with a larger sample, in order to gain a greater understanding of the detrimental effects of hours playing versus years playing. 相似文献